PDF Finding Public Health Statistics and Data Sources

FINDING PUBLIC HEALTH STATISTICS AND DATA SOURCES

Catherine R. Selden

Chapter Summary

Finding data sources and effectively using statistics are of vital importance as national, state, and local public health departments are called upon to respond quickly to ever more pressing emergencies. The importance of health data and a brief discussion of how to find statistics and data sources are discussed in this chapter. Also, a case study is used to illustrate how Web sites offering data sets and statistics can be useful in public health practice.

Note that the text of this chapter is in the public domain and may be copied, adapted and used freely for the training of members of the public health workforce.

Learning Objectives

Public health workers learning the material in this chapter will: ? Have a general understanding of the types of statistics and data sets that are available on the Internet ? Be able to identify selected Web sites with data sources and statistics for use at the national, state, and local public health levels.

Applications of Learning

The strategies and resources introduced in this chapter will enhance a public health worker's competency in:

Analytic/Assessment Skills: Identifies relevant and appropriate data and information sources [1]

Introduction

Technology has markedly improved access to public health statistics. These statistics are derived from data sets which are collections of logically related data arranged in a prescribed manner. Data may represent information collected at the national, state or local levels. Public health data sets may be conveniently envisioned as falling into two broad categories. One category includes counts of individual health related events or services. Counts are made of individuals who are provided particular health services. These counts are normally geographically and chronologically proscribed. For example,

This chapter is based on: "Finding and Using Health Statistics," a course prepared by Dan Melnick, Ph.D., under the sponsorship of the National Library of Medicine. The original course is available on the NICHSR Web site at:

Suggestions for Trainers

one collection of data might focus on a population in the northeast United States between 1960 and 1980 while another might be limited to citizens of West Virginia. Specific events might include hospital emergency room visits, visits to WIC clinics, deaths attributed to a specific cause, and preventive services including cancer screenings or immunizations. Such counts of events, once aggregated, are useful in assessing general health needs and status, setting reimbursement levels, determining eligibility, evaluating care and program coverage and penetration rates. However, because data collection is limited to those who seek services, the results may or may not be representative of the general population.

A second category of data sets describes populations through the use of sampling techniques. Data collection systems that create these data sets survey a subset of a reference population. The reference population could be as broad as all citizens of the United States or it may be more narrowly constrained. Examples include many of the federal surveys of health status and health behaviors and health services utilization. The sampling techniques are used to identify an appropriate survey population [2].

Statistical reports including a mix of text, tables, and figures from data sets are available from an increasing number of federal, state and local sources through a variety of electronic modes including the Internet.

Important Features of Health Statistics and Data Sets

The Importance of Health Data Health statistics and data are important because they measure a wide range of health indicators for a community. A community can be the entire United States, a region, state, county, or city. Health data provide comparisons for clinical studies, can be used to assess costs of health care, can help identify needed prevention targets for such programs as Healthy People 2010 and are important for program planning and evaluation by finding a baseline against which to measure in the evaluation phase.

The Context of Health Statistics Health statistics are influenced by an organization's perspective and bias. These biases can affect the collection device and eventual outcomes that are reported. They also can determine what data are collected and how the data are collected. Whenever possible, read the notes describing the reasons for and methods of data collection. Remember that statistics are collected to meet the needs of the collector.

The populations covered by different data collections systems may not be the same. Data on vital statistics and national expenditures cover the entire population. Most data on morbidity and utilization of health resources cover only the civilian non-institutionalized population.

Some information is collected in more than one survey and estimates of the same statistic may vary among surveys. For example, the National Health Interview Survey, the National Survey on Drug Use and Health, the Monitoring the Future Survey, and the Youth Risk Behavior Survey all measure cigarette use. But estimates of cigarette use may differ among these surveys because of different survey methodologies, sampling frames, questionnaires, definitions, and tabulation categories.

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Key Features of Health Statistics Health statistics are population based and many are collected and analyzed over time. Statistics often use geographic regions such as zip codes for determining health care coverage and comparisons of specific disease occurrences. Most studies focus on variation over time, space and social group.

Health Statistics Come from Diverse Sources Many studies use administrative data. Administrative data, according to the Centers for Medicare and Medicaid Services (CMS), include enrollment or eligibility information, claims information, and managed care encounters. The claims and encounters may be for hospital and other facility services, professional services, prescription drug services, laboratory services or other services.

Surveys are designed to collect specific data and are often conducted by trained personnel who administer them by telephone or in-person.

CDC states that public health surveillance is the systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis, to gain knowledge of the pattern of disease occurrence and potential in a community, in order to control and prevent disease in the community.

Health Data on the Web

Statistical Information on the Web The Internet is a good place to look for already compiled statistics. Current data from federal, state and local governments as well as non-governmental health statistical sources are increasingly available. Access to spatial information is becoming easier, allowing the creation of maps for visualizing statistical information. Keep in mind that while the Internet is a valuable tool, it is not the complete answer.

Remember that Web sites are produced by organizations for a variety of purposes. Web sites provide a variety of information in many formats including:

? Summaries and secondary material ? Full reports with tables ? Digital versions of data ? Full data sets

Statistical Information Not on the Internet Not all health data sets and statistics are freely or publicly available on the Web. In some cases only summaries or partial data sets are available and the full sets must be purchased. New privacy concerns as a result of the HIPPA regulations may cause organizations to limit access to data. For example, the Centers for Medicare and Medicaid Services (CMS) states on its Web site that some data sets are so limited that a Medicare beneficiary might be identified when files are relinked although all direct identifiers are stripped out. CMS requires a signed Data Use Agreement (DUA) between CMS and the requestor to ensure that the data are protected in these files.

Suggestions for Trainers

Finding Statistics and Data Sets on the Web There are umbrella Web sites that point to statistical information and data resources. These are called portals and search engines. A portal is a Web site that is commonly used as a gateway to other Web sites. A search engine is a computer program that retrieves documents, files or data from a database or from a computer network (especially from the Internet). Search engine algorithms may give a higher ranking to a site that contains the keyword(s) that are specified by the user. Google is an example of a search engine that points to numerous statistics and data resources across the World Wide Web.

Case Study: Prevention of smoking among teens.

Ms. McBeal, a health educator in Lostlake, West Virginia is interested in developing a promotional campaign to decrease smoking among teens. To interest key players in the community she wants to create a presentation with information about tobacco use among teens with national, state and local statistical data, causes, adverse effects, and prevention.

Search Tips for Google on Smoking and Teens

Click on Advanced Search Enter smoking on the first line, Enter "youth teens children" on the line marked "with at least one of the words," Scroll down to Domain, Enter .gov (This will narrow the search to only government Web sites.) Google Results include: MedlinePlus ? Smoking and Youth

What are Internet Portals? Internet Portals are subject focused, information directories. Typically they do not have their own local content. They point to content created by others. Key word searches within portals can be effective. However, not all portals have keyword searching. You need to know what you are looking for and you need to identify the correct information portal for that need. Several are listed in the material that follows.

Health Statistics Portals/Gateways

Suggestions for Trainers

Partners in Information Access for the Public Health Workforce

MedlinePlus See Health Topic ? Health Statistics

HSS Data Council Gateway to Data and Statistics ? Federal Government

Statistical Abstract of the United States ? U.S. Census Bureau

FedStats ? Federal Government

State & County QuickFacts ? U.S. Census Bureau ? Federal Government

Statistical Resources on the Web ? University of Michigan

State Health Facts Online - Kaiser Family Foundation

Federal Government Health Statistics Agencies

There are several federal agencies that gather, analyze, and report statistical data useful for public health purposes. Among these are:

National Center for Health Statistics (NCHS) This is the principal health statistics agency in the U.S. It is part of the Centers for Disease and Control and Prevention (CDC).

Agency for Healthcare Research and Quality (AHRQ) AHRQ is the lead scientific research federal agency charged with supporting research designed to improve the quality of healthcare, reduce its cost, improve patient safety, decrease medical errors, and broaden access to essential services.

Substance Abuse and Mental Health Services Administration (SAMHSA) SAMHSA's Office of Applied Studies (OAS) provides the latest national data on 1) alcohol, tobacco, marijuana and other drug abuse, 2) drug related emergency department episodes and medical examiner cases, and 3) the nation's substance abuse treatment system.

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